Provider Demographics
NPI:1689786162
Name:ONCOLOGY CARE MEDICAL ASSOCIATES
Entity Type:Organization
Organization Name:ONCOLOGY CARE MEDICAL ASSOCIATES
Other - Org Name:ONCOLOGY CARE MEDICAL ASSOCIATES
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:IRA
Authorized Official - Middle Name:E
Authorized Official - Last Name:FELMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:323-726-7535
Mailing Address - Street 1:101 E BEVERLY BLVD
Mailing Address - Street 2:STE 200
Mailing Address - City:MONTEBELLO
Mailing Address - State:CA
Mailing Address - Zip Code:90640-4300
Mailing Address - Country:US
Mailing Address - Phone:323-726-7535
Mailing Address - Fax:323-726-2544
Practice Address - Street 1:101 E BEVERLY BLVD
Practice Address - Street 2:STE 200
Practice Address - City:MONTEBELLO
Practice Address - State:CA
Practice Address - Zip Code:90640-4315
Practice Address - Country:US
Practice Address - Phone:323-726-7535
Practice Address - Fax:323-726-2544
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2010-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CALAB19511FMedicaid
0540050001Medicare NSC